Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Vascular 2 > Module 5 : Peripheral Arterial System Part 1 > Flashcards

Module 5 : Peripheral Arterial System Part 1 Flashcards

1
Q

14 risk factors for peripheral arterial disease

A
  • diabetic
  • hypertension
  • hyperlipidemia
  • coronary artery disease
  • previous history of CVA or MI
  • smoking
  • age
  • family history
  • male
  • obesity
  • sedentary lifestyle
  • elevated levels of homocysteine
  • excessive levels of C-reactive protein
  • history of radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why diabetes is a risk factor for peripheral arterial disease

A
  • atherosclerosis
  • medial wall calcification common
  • high incidence of gangrenous changes leading to amputation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what arteries have high incidence of occlusion with diabetes

A
  • popliteal

- tibial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

why is hypertension a risk for peripheral arterial disease

A
  • increased incidence of peripheral and cerebral atherosclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why is smoking a risk factor for peripheral arterial disease

A
  • irritates endothelial lining and causes vasoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are 4 physical signs of peripheral arterial disease

A
  • skin changes
  • palpations
  • auscultations
  • limb pressures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the 9 skin changes that can occur with peripheral arterial disease

A
  • pallor
  • rubor
  • dependant rubor
  • cyanosis
  • temperature
  • ulcers
  • gangrene
  • trophic changes
  • capillary refill time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is pallor

A
  • pale color secondary to deficient blood supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is rubor

A
  • dark reddish color or discolouration from dilated or damaged vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is dependant rubor

A
  • limb takes on pallor when elevated but becomes abnormally red when hanging dependant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is cyanosis

A
  • bluish color of the skin and mucous membranes that results from a concentration of deoxygenated hemoglobin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does skin temperature change with peripheral arterial disease

A
  • skin feels cool to the touch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are ulcers

A
  • deep, irregular shaped areas over the tibial area and are very painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is gangrene

A
  • results from death of tissue form absent blood supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are trophic changes

A
  • due to lack of nourishment

- shiny, scaly skin, thick toenails and loss of hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what capillary refill time

A
  • pressure is applied to an area of the skin and released
  • color return should be immediate
  • increase in this time indication of poor arterial supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how to grade and check pulses

A
  • graded from 0-4 where 0 is no pulse and 4 is a bounding pulse
  • compare sides
  • diminished or absent pulses suggest arterial insufficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what kind of pulse with an aneurysm have

A
  • bounding pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is a bruit

A
  • abnormal low frequency sounds that can be caused by a significant stenosis graded from 1-3
  • in a > 90% stenosis bruit is not heard
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does a difference in limb pressures indicate

A
  • difference in pressures side to side may indicate disease or > 20 mmHg in upper and low extremity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are 4 symptoms of peripheral arterial disease

A
  • claudication (intermittent)
  • ischemic rest pain
  • necrosis
  • pseudoclaudication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is intermittent claudication

A
  • muscle pain that occurs during exercise but subsides at rest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is claudication caused by

A
  • lack of blood supply to a group of muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

is claudication reproducible

A
  • yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are 4 common sites of claudication
- hip - thigh - butt - calf
26
where is the site of disease relative to where the claudication occurs
- proximal
27
what does butt claudication suggest
- distal aortoiliac disease
28
what does which claudication suggest
- distal external iliac/CFA disease
29
what does calf claudication suggest
- femoral / popliteal disease
30
what is ischemic rest pain indicate
- always an indicator of advanced multisegment disease | - precursor to limb loss unless treated
31
what is the pain with ischemic rest pain
- severe and CONSTANT
32
what area is usually affected by ischemic rest pain
- dorm (top) of foot and toes
33
does rest relieve ascetic rest pain
- no
34
what is necrosis
- tissue death | - end stage of absent blood supply
35
what is the most severe symptom of ischemic rest pain
- necrosis
36
what is pseudoclaudication
- pain caused by other factors such such as degenerative joint disease, spinal stenosis, herniated discs
37
is pseudoclaudication reproducible
- no
38
what are 3 mechanisms of peripheral arteriole disease
- atherosclerosis - embolism - aneurysm
39
where is the most common location of atherosclerotic disease in the lower extremity
- SFA at the adductor canal
40
what are 2 other common sites of obstruction in lower extremity
- partial bifurcations | - popliteal artery
41
can atherosclerotic disease be focal or diffuse and what levels does it affect
- both | - may affect any level or multiple levels
42
how can an embolism causes disease
- from stenotic plaque formation
43
what is an aneurysm
- dilation of all walls of vessel | - may contain large amounts of thrombus
44
what are aneurysms usually due to
- trauma | - atherosclerosis
45
what are 3 common areas of aneurysm
- abdominal aorta AAA - femoral - popliteal artery
46
what are the two common areas of upper extremity aneurysms
- subclavian aneurysms | - ulnar aneurysms
47
what can subclavian aneurysms cause
- cause of embolization to distal arteries of the hand
48
what is most common cause of subclavian aneurysms
- result of compression of the subclavian artery due to THORACIC OUTLET SYNDROME
49
what are ulnar aneurysms caused by
- due to trauma from using hand as a hammer | - HYPOTHENAR HAMMER SNYDROME
50
what are 5 sonographic features of aneurysms
- increased diameter by > 50% - image and measure in sag trans AP - OUTER WALL TO OUTER WALL - color doppler shows to and fro flow along outer wall - measure actual lumen size if thrombus present
51
what are the 5 uses of duplex peripheral arterial testing
- determine STENOSIS OR OCCLUSION - evaluate BYPASS GRAFTS - presence or absence of ANEURYSMS - locate stenotic lesions PRE SURGERY OR GRAFT - FOLLOW UP
52
what are three limitations to duplex testing
- surface obstructions (dressings staples wounds) - obesity - Ca +++ in walls (arteriosclerosis)
53
11 indications for extremity duplex
- claudication - rest pain - extremity ulcer - gangrene - absent peripheral pulses - digital cyanosis - arterial trauma - aneursymal disease - abnormal ABI/WBI/TBI - dependant rubor - bruit
54
what is one specific indication for a lower extremity duplex exam
- decrease in ABI > 0.15 compared to previous exam
55
what are 5 specific indications for upper extremity duplex exam
- abnormal arterial arm pressures (>20mmHg) - thoracic outlet symptoms - prior to dialysis - cold sensitivity - raynauds syndrome
56
what do we look for in the 2D images in duplex exam
- vessel identification and lie of vessels | - assess walls for plaque
57
what doe we look for in the color imaging in duplex exams
- locate and follow vessels - vessel patency (stenosis or occlusion) - flow direction - plaque - placement of doppler sample - grafts and bypass - aneurysms - follow up
58
what three things do we asses with pulsed doppler
- confrims patency of vessels - quantifies flow speed - waveform assessment
59
what arteries are assessed in LE duplex
- distal external iliac - CFA - CFA bifur - SFA - pop a - trifurcation
60
what is the protocol in areas of suspected stenosis
- measure luminal reduction to help verify velocity data in hemodynamically significant stenosis - obtain highest achievable velocity through any areas of stenosis - obtain spectral information prox and distal to any stenosis - MEASURE LUMEN REDUCTION IN GRAY SCALE
61
what vessels are assessed in upper extremity duplex exam
- subclavian (prox and dist) - axillary - brachial - radial - ulnar - palmar arch if necessary
62
what is normal PSV of SCA and AXA
70-120 cm/s
63
what is normal PSV BrA
50-120cm/s
64
what is normal PSV of RA and UA
40-90cm/s
65
what should you do with the sample volume when stenosis is discovered
- walk the sample volume through the area to obtain representative velocities + 2cm prox, highest PSV, distal to stenosis
66
what 4 criteria should we determine in peripheral arterial disease
- plaque location and characteristics - PSV and flow characteristics - V2/V1 (V2 represents the max PSV and V1 PSV in normal) - any change in spectral
67
what should normal gray scale and color look like in duplex exam
- no echoes seen within the lumen | - color doppler fills lumen wall to wall
68
what should normal doppler trace look like in normal LE duplex
- triphasic - biphasic may be present without any visualized stenosis and may be considered normal - abnormal would be change from tri to bi
69
are PSV uniform normal LE duplex
- yes
70
what is mean PSV in external iliac
120 +/- 22 cm/s
71
what is mean PSV in CFA
114 +/- 25 cm/sec
72
what is mean PSV in SFA prox
91 +/- 14 cm/s
73
what is mean PSV in SFA dist
94 +/- 14 cm/s
74
what is mean PSV in pop
69 +/- 13cm/s
75
what would gray scale and color look like in an abnormal LE duplex
- intraluminal echoes are sen and decreased lumen measures - color doppler does not fill entire lumen and color jet seeing narrowed segment - color mosaic see due to post stenotic turbulence
76
what would abnormal biphasic doppler signals look like in abnormal LE duplex testing
- strong forward flow in early systole (sharp upstroke) - loss of flow in early diastole (non flow below baseline) - decrease in late diastolic component
77
what would abnormal monophasic flow doppler signals look like in abnormal LE duplex testing
- decreased pulsatility and no reversed flow in late systole - diastolic flow may or may not be seen - blunted systolic component t - common distal to hemodynamically significant stenosis or occlusion
78
what does a focal velocity increase of >/= double of the prox segment indicate
- hemodynamically significant lesion > 50%
79
what does a focal velocity increase of >/= triple of the prox segment indicate
- hemodynamically significant lesion of > 70%
80
what 4 other things indicate presence of stenosis
- spectral wave form changes - post stenotic turbulence - color aliasing - color bruit
81
what are 3 indirect signs of stenosis when a proximal normal velocity cannot be obtained
- increased velocities with luminal reduction and post stenotic turbulence - spectral waveform changes form one segment to next - arterial wave form comparison at the same site in contralateral artery
82
what does a staccato wave form indicate
- severe distal stenosis or complete distal occlusion
83
what color parameter indicates a complete occlusion
- flow not detected by cold and spectral doppler in vessel
84
the presence of what vessel can help indicate occlusion extent
- large collateral at the pool and distal ends
85
what characteristics (waveform spectral broadening velocity and distal waveform) will a normal vessel present with
- triphasic - none - none - normal
86
what characteristics (waveform spectral broadening velocity and distal waveform) will a vessel with 1-19% stenosis present with
- triphasic - minimal - < 30% increase in PSV from proximal segment - normal prox and distal
87
what characteristics (waveform spectral broadening velocity and distal waveform) will a vessel with 20-49% stenosis present with
- tri/biphasic - prominent - 30-100% increase in PSV from prox segment - normal prox and distal
88
what characteristics (waveform spectral broadening velocity and distal waveform) will a vessel with 50-99% stenosis present with
- monophasic - extensive - > 100% increase in PSV from prox segment - waveform monophasic distal
89
what characteristics (waveform spectral broadening velocity and distal waveform) will a completely occluded vessel present with
- no flow (pre occlusive thump prox) - none - none - collateral waveform monphasic with reduced PSV
90
what are 3 other correlative diagnostic tests
- CTA - MRA - arteriography
91
what are 5 medical treatments of peripheral arterial disease
- modify risk factors - exercise routine - anti-platelet medications - anticoagulation - thrombolysis
92
what are 5 surgical treatments of peripheral arterial disease
- bypass grafting - artherectomy - resection - sympathectomy - amputation
93
what are 3 Endovascular treatments of peripheral arterial disease
- angioplasty - stent - intraarterial directed thrombolysis

Vascular 2 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions